Long COVID: Are mitochondria to blame for fatigue after exercise?

Evan Walker
Evan Walker TheMediTary.Com |
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What causes fatigue after exercise in people with long COVID? Image credit: M Stone/Stocksy.
  • At least 65 million people globally have long COVID.
  • The most common symptoms of long COVID include post-exertional malaise, cognitive impairment, brain fog, sleep problems, and fatigue, which can have a severe impact on a person’s life.
  • Researchers are still unsure why some people develop long COVID and its symptoms while others do not.
  • Researchers from the Amsterdam University Medical Center have discovered that the fatigue experienced by those with long COVID has a physical cause.

At least 65 million people around the world have long COVID, a condition where they continue to experience COVID-19 symptoms for months after their symptoms originally start.

The most common symptoms of long COVID are fatigue, dizziness, mobility issues, sleep problems, cognitive impairment, and brain fog or inability to concentrate.

These types of lingering symptoms can have a profound impact on a person’s life. A study published in June 2023 found more than half of people with long COVID reported their work, home, social, and private lives were severely impacted by the symptoms, with fatigue being the main problem.

Scientists are still unsure as to why some people develop long COVID and its symptoms while others do not.

Now researchers from the Amsterdam University Medical Center are helping to provide some answers with their new study — recently published in the journal Nature Communications — that found the fatigue experienced by those with long COVID has a physical cause.

MNT also spoke with Dr. David Cutler, a board-certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, about this study. Dr. Cutler was not involved in the research.

Dr. Cutler commented that the topic of long COVID sparks controversy and strong emotions because it remains poorly defined, difficult to diagnose, and challenging to treat.

“Despite scientific consensus about its existence, the lack of a definitive diagnostic test and its variable presentation continues to make many skeptical of its existence,” he explained. “As a clinician, [I find that] this [research] is helpful in reassuring long COVID sufferers that what they are experiencing is physically real, and not merely psychological.”

“Lacking a specific cure for this condition, the most important treatment physicians can provide is reassurance,” Dr. Cutler continued.

“Patients must be allowed [an] opportunity to present their symptoms to a receptive physician, they must be thoroughly evaluated to exclude other conditions, the diagnosis of long COVID should then be specifically endorsed, patients need to be informed of the generally favorable long-term prognosis, and adequate follow-up provided. This is the basis for optimal reassurance.”

– Dr. David Cutler

Regarding fatigue, Dr. Cutler said a program of graded exercise to avoid worsening symptoms seems to be best.

“However, at this point, the findings of this one study of just 25 patients does not significantly enhance our ability to treat these patients’ complaints of fatigue,” he added. “But it does help to explain their symptoms which aids in reassurance and lessens anxiety. Future research could be aimed at attempts to lessen fatigue with various regimens of exercise, nutritional support, and emotional therapy to ease the suffering of those with long COVID.”

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